Individual
DR. ANITA L WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D., CGP
Contact information
Practice address
MANCHESTER VA MEDICAL CENTER, 718 SMYTH ROAD, MANCHESTER, NH 03110
(603) 624-4366
Mailing address
38 HAWTHORNE DR, F-303, BEDFORD, NH 03110-6895
(603) 703-3660
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000010344
TN
Other
Enumeration date
10/02/2006
Last updated
07/30/2007
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